Organization
PRINCE GEORGE COSMETIC & FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON GILL BOWMAN DDS (PRESIDENT)
(804) 862-4416
Entity
Organization
Contact information
Practice address
5727 ALLIN RD, PRINCE GEORGE, VA 23875-2343
(804) 862-4416
(804) 862-4428
Mailing address
5727 ALLIN RD, PRINCE GEORGE, VA 23875-2343
(804) 862-4416
(804) 862-4428
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410885
VA
Other
Enumeration date
04/17/2009
Last updated
04/17/2009
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